tetano
Editor, Senior Moderator
Vaccine. 2017 Apr 10. pii: S0264-410X(17)30437-1. doi: 10.1016/j.vaccine.2017.03.085. [Epub ahead of print]
[h=1]Effectiveness of live attenuated influenza vaccine and inactivated influenza vaccine in children during the 2014-2015 season.[/h] McLean HQ[SUP]1[/SUP], Caspard H[SUP]2[/SUP], Griffin MR[SUP]3[/SUP], Poehling KA[SUP]4[/SUP], Gaglani M[SUP]5[/SUP], Belongia EA[SUP]6[/SUP], Talbot HK[SUP]3[/SUP], Peters TR[SUP]4[/SUP], Murthy K[SUP]5[/SUP], Ambrose CS[SUP]2[/SUP].
[h=3]Author information[/h] 1 Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI 54449, USA. Electronic address: mclean.huong@marshfieldclinic.org. 2 MedImmune, One MedImmune Way, Gaithersburg, MD 20878, USA. 3 Vanderbilt University Medical Center, 1161 21st Avenue S, Nashville, TN 37232, USA. 4 Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA. 5 Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, 2401 South 31st Street, Temple, TX 76508, USA. 6 Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI 54449, USA.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] A clinical study found that live attenuated influenza vaccine (LAIV) was superior to inactivated influenza vaccine (IIV) against drifted A(H3N2) viruses in children. During the 2014-2015 influenza season, widespread circulation of antigenically and genetically drifted A(H3N2) viruses provided an opportunity to evaluate subtype-specific vaccine effectiveness (VE) of quadrivalent LAIV (LAIV4) and IIV in children.
[h=4]METHODS:[/h] Children (2-17years) with febrile acute respiratory illness <5days' duration were enrolled at 4 outpatient sites in the United States during the 2014-2015 influenza season. Nasal swabs were tested for influenza by reverse transcription polymerase chain reaction; vaccination dates were obtained from medical records or immunization registries. VE was estimated using a test-negative design comparing odds of vaccination among influenza cases and test-negative controls with adjustment for potential confounders.
[h=4]RESULTS:[/h] Among 1696 children enrolled, 1511 (89%) were included in the analysis. Influenza was detected in 427 (28%) children; 317 had influenza A(H3N2) and 110 had influenza B. Most influenza isolates were characterized as a drifted strain of influenza A(H3N2) or a drifted strain of B/Yamagata. For LAIV4, adjusted VE was 50% (95% confidence interval [CI], 27-66%) against any influenza, 30% (95% CI, -6% to 54%) against influenza A(H3N2), and 87% (95% CI, 63-96%) against type B. For IIV, adjusted VE was 39% (95% CI, 18-54%) against any influenza, 40% (95% CI, 16-58%) against A(H3N2), and 29% (95% CI, -15% to 56%) against type B. Odds of influenza for LAIV4 versus IIV recipients were similar against influenza A(H3N2) (odds ratio [OR], 1.17; 95% CI, 0.73-1.86) and lower against influenza B (OR, 0.18; 95% CI, 0.06-0.55).
[h=4]CONCLUSIONS:[/h] LAIV4 and IIV provided similar protection against a new antigenic variant A(H3N2). LAIV4 provided significantly greater protection than IIV against a drifted influenza B strain. ClinicalTrials.gov identifier: NCT01997450.
Copyright ? 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
[h=4]KEYWORDS:[/h] Influenza; Influenza vaccine; Pediatrics; Vaccine effectiveness
PMID: 28408121 DOI: 10.1016/j.vaccine.2017.03.085
[h=1]Effectiveness of live attenuated influenza vaccine and inactivated influenza vaccine in children during the 2014-2015 season.[/h] McLean HQ[SUP]1[/SUP], Caspard H[SUP]2[/SUP], Griffin MR[SUP]3[/SUP], Poehling KA[SUP]4[/SUP], Gaglani M[SUP]5[/SUP], Belongia EA[SUP]6[/SUP], Talbot HK[SUP]3[/SUP], Peters TR[SUP]4[/SUP], Murthy K[SUP]5[/SUP], Ambrose CS[SUP]2[/SUP].
[h=3]Author information[/h] 1 Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI 54449, USA. Electronic address: mclean.huong@marshfieldclinic.org. 2 MedImmune, One MedImmune Way, Gaithersburg, MD 20878, USA. 3 Vanderbilt University Medical Center, 1161 21st Avenue S, Nashville, TN 37232, USA. 4 Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA. 5 Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, 2401 South 31st Street, Temple, TX 76508, USA. 6 Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI 54449, USA.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] A clinical study found that live attenuated influenza vaccine (LAIV) was superior to inactivated influenza vaccine (IIV) against drifted A(H3N2) viruses in children. During the 2014-2015 influenza season, widespread circulation of antigenically and genetically drifted A(H3N2) viruses provided an opportunity to evaluate subtype-specific vaccine effectiveness (VE) of quadrivalent LAIV (LAIV4) and IIV in children.
[h=4]METHODS:[/h] Children (2-17years) with febrile acute respiratory illness <5days' duration were enrolled at 4 outpatient sites in the United States during the 2014-2015 influenza season. Nasal swabs were tested for influenza by reverse transcription polymerase chain reaction; vaccination dates were obtained from medical records or immunization registries. VE was estimated using a test-negative design comparing odds of vaccination among influenza cases and test-negative controls with adjustment for potential confounders.
[h=4]RESULTS:[/h] Among 1696 children enrolled, 1511 (89%) were included in the analysis. Influenza was detected in 427 (28%) children; 317 had influenza A(H3N2) and 110 had influenza B. Most influenza isolates were characterized as a drifted strain of influenza A(H3N2) or a drifted strain of B/Yamagata. For LAIV4, adjusted VE was 50% (95% confidence interval [CI], 27-66%) against any influenza, 30% (95% CI, -6% to 54%) against influenza A(H3N2), and 87% (95% CI, 63-96%) against type B. For IIV, adjusted VE was 39% (95% CI, 18-54%) against any influenza, 40% (95% CI, 16-58%) against A(H3N2), and 29% (95% CI, -15% to 56%) against type B. Odds of influenza for LAIV4 versus IIV recipients were similar against influenza A(H3N2) (odds ratio [OR], 1.17; 95% CI, 0.73-1.86) and lower against influenza B (OR, 0.18; 95% CI, 0.06-0.55).
[h=4]CONCLUSIONS:[/h] LAIV4 and IIV provided similar protection against a new antigenic variant A(H3N2). LAIV4 provided significantly greater protection than IIV against a drifted influenza B strain. ClinicalTrials.gov identifier: NCT01997450.
Copyright ? 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
[h=4]KEYWORDS:[/h] Influenza; Influenza vaccine; Pediatrics; Vaccine effectiveness
PMID: 28408121 DOI: 10.1016/j.vaccine.2017.03.085